CS - Pale mucous membranes

Question 1

What do ghost cells indicate on blood smear?

Answer 1

intravascular haemolysis

Question 2

What do spherocytes indicate?

Answer 2

extravascular haemolysis

Question 3

Describe haemolysis in IMHA

Answer 3

extravascular and intravascular components

Question 4

Cause -rubricytosis

Answer 4

• marked regenerative process (anaemia)

- BM hypoxia may also contribute

Question 5

Causes - secondary IMHA

Answer 5

• infection
• neoplasia
• drug exposure
• dx of primary IMHA is one of exclsuion

Question 6

What is Evans’ syndrome?

Answer 6

When IMTP occurs concurrently with IMHA

Question 7

Side effects -corticosteroids

Answer 7

thirst urination, increased appetite and weight gain, panting, mm weak, increased ifxn susceptibility d/t suppressed I.S.

Question 8

Why is azathioprine used with corticosteroids nowadays in tx of IMHA?

Answer 8

so that lower dose corticosteroids can be used, BUT risk of acute pancreatitis

Question 9

CS - acute pancreatitis

Answer 9

vomiting, marked cranial abdominal discomfort, inappetence, lethargy, then canine pancreatic lipase for biochem evidence

Question 10

How does human IVIG work with IMHA tx?

Answer 10

occupies Fc –R on macrophages preventing opsonisation of IgG coated RBCs, controversial efficacy and not widely available in vet med.

Question 11

Why is risk of thromboembolism high in primary IMHA?

Answer 11

d/t release of pro-coagulant molecules, low dose aspirin, heparin often to prevent thrombi, dose to individual

Question 12

Prognosis - IMHA

Answer 12

• fair to guarded,
• roughly 30-50% animals survive 1 y after initial tx,
• highest mortality in first 2 weeks,
• anaemia is not usually fatal but the complications (thromboembolic effects),
• dogs usually do well long term if cope well with acute tx, generally life-long tx.
• Usually have excellent QoL.

Question 13

What are codocytes?

Answer 13

• mexican hat/ target cells

- linked with Fe deficiency

Question 14

Why do you tend to have low Ca with low protein?

Answer 14

d/t fact that Ca is carried by albumin so low albumin means low Ca. To determine if there is a genuine low Ca, run a test for free Ca concentration.

Question 15

List examples of SI cancer

Answer 15

intestinal adenocarcinoma, leiomyoma, leiomyosarcoma, lymphoma, MCT, GIT stromal tumour (GIST), carcinoid and rarely plasma cell tumour or rarely HAS.

Question 16

T/F: anaemic patients (low PCV) will have a higher absolute reticulocyte count than normal patient

Answer 16

True

Question 17

Intestinal adenocarcinoma -signlment

Answer 17

intestinal adenocarcinoma, leiomyoma, leiomyosarcoma, lymphoma, MCT, GIT stromal tumour (GIST), carcinoid and rarely plasma cell tumour or rarely HAS.

Question 18

Main CS - intestinal adenocarcinoma

Answer 18

wt loss and vomiting d/t intestinal obstruction

Question 19

Location - intestinal adenocarcinoma

Answer 19

can affect stomach, SI, LI and rectum

Question 20

Tx - intestinal adenocarcinoma

Answer 20

• complete sx excision if possible (midline laparotomy)
• chemo usually unsuccessful
• radiotherapy not possible d/t local tissue intolerance

Question 21

Prognosis - intestinal adenocarcinoma

Answer 21

• good if complete sx excsion possible
• mets to local LNs common by time of dx
• re-examine q3mo
• Gastric neoplasm: MST is 2 months
• Intestinal neoplasm: MST is 10 months
• Gastric: high risk complications

Question 22

Types - MCT

Answer 22

unlike cutaneous form is relatively uncommon (i.e. GIT type), haematopoietic and GIT types

Question 23

Tx and Px - intestinal MCT

Answer 23

sx remove whole spleen or GIT affected. poor prognosis within 2 months first admission, no chemo as short MST, NSAIDs to reduce inflammation, special diet to reduce irritation of GIT

Question 24

Describe intestinal lymphoma

Answer 24

alimentary form arises form mesenteric LN

Question 25

Tx - intestinal lymphoma

Answer 25

sx, radiotherapy and chemo (COP),

Question 26

Px - intestinal lymphoma

Answer 26

no tx 6-8 wks, corticosteroids 3 mo, chemo 6-12 mo. Dogs generally do poorly cats well. Determine if high or low grade before offering prognosis. BC type gets a better response to certain chemo protocols than TC types. sc can be used alongside chemo for focal masses

Question 27

T/F: GIT neoplasms tend to be malignant

Answer 27

Ture

Question 28

How common are GIT neoplasms?

Answer 28

• uncommon in cats and dogs

- Gastric tumours

Question 29

Define leiomyosarcoma

Answer 29

malignant SMC tumour

Question 30

Tx - leiomyosarcoma

Answer 30

• Surgery – BEST CHOICE - complete excision may not be possible
• Chemotherapy – anecdotal. Possible choices include doxorubicin, platinum agents, and ifosfamide.

Question 31

Px - leiomyosarcoma

Answer 31

Study survival times range from 0 to 47 months, with an approximate MST of 12
21.3months MST if initial post-op period survived (Cohen et al 2003)
Dogs with histologically documented metastasis had similar survival time

Question 32

Tx - aplastic anaemia d/t hyperoestrogenism associated with sertoli cell tumour

Answer 32

• Initial symptomatic – stabilise for blood dyscrasia, normalise [RBC] with PRP/ WB
• Standard tx – castration + scrotal ablation
• Others – Abx, hemantinics, blood products

Question 33

Px - aplastic anaemia d/t hyperoestrogenism associated with sertoli cell tumour

Answer 33

better for scrotal tissue (as in this case), oestrogenic signs resolve 1-2 mo after castration, DM suppression can be chronic

Question 34

Reasons for tx failure with sertoli cell tumour - induced hyperoestrogenism

Answer 34

metastatic dz, failure to recover form blood dyscrasia (i.e. the aplastic anaemia), death d/t haemorrhage form thrombocytopaenia/ anaemiarf